title: Use of diagnostic ultrasound, X-ray examinations, and electronic fetal monitoring in perinatal medicine.
abstract: Obstetrical technologies such as electronic fetal monitoring (EFM) and selected diagnostic imaging procedures can be integral components of perinatal care. The Center for Devices and Radiological Health, a unit within the Food and Drug Administration, collaborated with the National Center for Health Statistics in the design and conduct of a National Maternal and Infant Health Survey to collect information from prenatal care providers, hospitals, and mothers on the use of EFM, diagnostic ultrasound, and x-ray examinations during pregnancy, labor, and delivery. A pretest, conducted some months before the survey began, showed that 78.8% of the pregnancies surveyed received a diagnostic ultrasound examination during pregnancy. Approximately 58.3% of the ultrasound-exposed mothers had two or more such examinations. Approximately 10.1% of the ultrasound examinations were performed in the first trimester of pregnancy, 57.0% in the second trimester, and 32.9% in the third trimester. The most common indication for an ultrasound examination was to establish dates or gestational age. Approximately 15.3% of the pregnancies surveyed received an x-ray examination. Approximately 74.6% of the pregnancies were monitored with EFM during labor. External EFM was used alone during 54.9% of the labors and along with internal EFM during 19.7% of the labors. The implications of these pretest findings are discussed, along with a review of the medical literature on the safety and effectiveness of these medical device technologies.
authors.affiliation: Center for Devices and Radiological Health, Food and Drug Administration, Rockville, MD 20852.
authors.forename: R M
authors.initials: RM
authors.lastname: Moore
authors.forename: L L
authors.initials: LL
authors.lastname: Jeng
authors.forename: R G
authors.initials: RG
authors.lastname: Kaczmarek
authors.forename: P J
authors.initials: PJ
authors.lastname: Placek
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004582:Electronics, Medical / Q000706:statistics & numerical data; D005260:Female; D005323:Fetal Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D005333:Fetus / Q000000981:diagnostic imaging*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007743:Labor, Obstetric; D010500:Perinatology / Q000706:statistics & numerical data; D011247:Pregnancy; D011859:Radiography; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology